Acute Care for the Elderly (ACE) is a model designed to address acutely ill elders by minimizing risks associated with hospitalization and maximizing or maintaining physical and cognitive functional levels during their stay. The ACE model incorporates four main principles into their concept, including patient- and family- centered care, a prepared physical environment, a specialized interdisciplinary team, and early discharge planning. The positive impacts of ACE include improved functional status, reduced rate of hospital readmission, decreased fall rates, shorter length of stay, reduced costs, and higher patient/provider satisfaction. The purpose of this research study was to understand the ACE model of care and identify environmental design strategies that support the physical, social, and psychological well-being of patients within the ACE unit and elder-friendly design. An integrative literature review was employed to identify design elements and considerations within the ACE units and hospitals for older adults, specifically within patient rooms. Key environmental facilitators in patient rooms for older adults include privacy, accessibility, familiarity, and social interaction. Designing an ACE unit that ensures the physical, social, and psychological well-being of the older adult requires knowledge of acute illness, age-related functionality, and elements of design needed to successfully carry out the model of care.